Exploring the Association of Sū’ Mizāj al-Kabid al-Bārid with the Clinical Profile of Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Observational Study

Background: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide and is strongly associated with obesity, insulin resistance, type 2 diabetes mellitus, and metabolic syndrome. Although Tashaḥḥum-i-Kabid Ghayr Khamrī not explicitly described in classical Unani literature, its clinicopathological features closely resemble Sū’-i-Mizāj al-Kabid al-Bārid, involving impaired hepatic temperament, defective metabolism, and fat accumulation. Objectives: To explore the etiopathogenesis of Tashaḥḥum-i-Kabid Ghayr Khamrī (NAFLD)from the Unani perspective, correlate classical concepts with contemporary medical understanding, and assess the role of Sū’-i-Mizāj al-Kabid and associated risk factors. Materials and Methods: An observational cross-sectional study was conducted on 60 ultrasonography-confirmed NAFLD patients attending the OPD/IPD of HAHRDM Hospital, State Unani Medical College, Prayagraj. Demographic characteristics, lifestyle factors, clinical features, laboratory investigations, ultrasonographic findings, Mizāj, and Sū’-i-Mizāj al-Kabid were assessed using a validated questionnaire developed from classical Unani literature. Statistical analysis was performed using Chi-square/Fisher's exact test at a 5% level of significance. Results: Most participants were females (65.0%) aged 41–50 years (43.3%). Balghamī Mizāj (76.7%) and Sū’-i-Mizāj al-Kabid al-Bārid (80.0%) predominated. Frequent consumption of fatty foods, sedentary lifestyle, and non-vegetarian dietary habits were common. Elevated AST (78.3%) and ALT (75.0%), dyslipidaemia, and Grade I fatty liver (71.7%) were the predominant laboratory and ultrasonographic findings.Conclusion: The findings suggest that Sū’-i-Mizāj al-Kabid al-Bārid, impaired Quwwat Ṭabī‘iyya, and unhealthy lifestyle factors contribute to Tashaḥm-ul-Kabid, supporting an integrated Unani and contemporary approach to its prevention and management. Keywords: Balghamī Mizāj, Non-Alcoholic Fatty Liver Disease, NAFLD, Sū’-i-Mizāj al-Kabid al-Bārid, Tashaḥḥum-i-Kabid Ghayr Khamrī, Unani Medicine